Tag Archives: complementary and alternative medicine

If you have been listening to the radio over the last few weeks you’ve probably heard about the amazing Lemon Detox Diet. “Detox” is one of the current buzz words in the alternative health sphere, it’s perfect because it’s not well defined but it carries a vague sense of helping your body to be healthy. If in doubt slap “Detox” in the name of your product and it’ll sell like hotcakes. I’ve written more generally about the Detox fad but I want to focus on this particular diet as it is currently very popular and so seems particularly harmful. The diet itself consists of Palm and Maple syrup, Lemon juice Cayenne  pepper and water, sounds nutritious. The regimen requires downing 2 litres of the diluted syrup a day for 10-14 days.

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Modern living can have it’s drawbacks as well as it’s advantages, nobody died in plane crashes 500 years ago. Some of the disadvantages come as a direct result of our increase in scientific and technological knowledge, there would be no antibiotic resistant bacteria without antibiotics. Some people worry about ever more subtle forms of danger in the modern world, there are those who classify themselves as “Electrosensitive”. Electrosensitives consider the electromagnetic fields produced by electronic products such as computers, cell phones, T.V.s, well almost everything these days, to be harmful in general and to affect them in particular in a variety of ways. Symptoms may include but not be limited to: headache, fatigue, tinnitus, dizziness, memory deficits and irregular heart beat, in fact there are lists including over thirty symptoms ranging from asthma to epilepsy and Alzheimer’s.

Earlier this year researchers at the University of Regensburg conducted a study of self identified electrosensitive sufferers comparing their reactions to non-sufferers when exposed to a heat-emitting thermode and a cell phone. The sufferers experienced discomfort from both stimuli where as non-sufferers only experienced discomfort from the thermode. This was backed up by brain scans of the subjects which indicated that the pain experienced was real. Unfortunately the phone used in the experiment was fake, there were no electromagnetic fields being produced. The sufferers were not making up the pain they felt, it was real to them, but in the same way that a placebo treatment can (allegedly*) make people feel better it appears that the anticipation of pain by the sufferers lead them to feel it, in a sort of nocebo response to the sham phone.

It seems that while these electrosensitive people are not merely attention seeking, as the discomfort they feel is undoubtedly real, neither are they suffering from a disability brought on by exposure to fields that are generally considered harmless. What’s going on here? I have no idea but I’ll be interested to see how further research sheds light on this.

Resources

http://www.sciam.com/podcast/episode.cfm?id=cell-phones-sometimes-cause-real-pa-08-10-13

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WNP-4SB7TW1-4&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_version=1&_urlVersion=0&_userid=10&md5=993618adacb00f6dc3c58a70d580feb2

http://en.wikipedia.org/wiki/Electrical_sensitivity

http://www.electrosensitivity.org/

* It’s complicated, it could be that what we refer to as a placebo response doesn’t actually exist and is really a mislabelling of other factors that have nothing to do with response to treatment. Who knows.

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About two months ago I wrote a piece describing the practice of Frequency Specific Microcurrent therapy (FSM) and attempted to show why I thought the practice was at best the premature use of an unproven modality and at worst a new way of parting the afflicted from their cash. This post recently attracted a comment from a Chiropractor named Pamela Hall who wished to defend the technique. As the comment was lengthy and covered a number of interesting points I thought I would post my reply as a blog entry. First I would like to thank Pamela Hall, DC, for her comment and I hope that I can reply to her in as thoughtful and considerate a way as she has conducted herself. Her comment starts:

Research that meets the gold standard of large patient numbers, with controls costs millions of dollars. There is very little money available for treatment that won’t make the drug companies or some other big players in the medical-industrial complex a lot of money. This is why the research doesn’t get done on this scale. In fact in the 1930’s all electrical therapies, herbs, and homeopathy were banned. They were a threat to the profit of drug companies and the AMA.

Firstly there have been well designed studies on other modalities that “won’t make the drug companies … a lot of money” such as acupuncture, I don’t see why this one should be any different. Also you have presented a false dichotomy here, the choice is not between large definitive clinical trials and nothing at all, smaller pilot studies published in reputable journals will do. If you can provide that I will be greatly appreciative, the best I could find was a case study which vaguely mentioned “microcurrent” along with several other treatment options. Given the amount of time the treatment has been in use I don’t think this is unreasonable.

Those who are prejudiced against so called “alternative healing” fail to acknowledge that western medicine has used aspirin simply because it worked without knowing the reason why until rather recently. The common treatment for angina is nitroglycerin put under the tongue, and this treatment was taken from the realm of homeopathy.

I will gladly acknowledge that much of conventional medicine has come from herbal preparations, folk remedies and the like and that medicines may be used without knowledge of the method of action. However, that the active constituent of Willow bark, salicylic acid (the precursor to acetylsalicylic acid or Aspirin) was extracted and purified which enabled the creation of medicines of consistent dose and quality, is all because of science. Just because a treatment can be obtained from a particular tradition or practice (such as homeopathy) does not lend credence to any of the other methods common to that source, they all must be evaluated separately on their merits, or lack thereof as the case may be. Also, especially in the case of Aspirin, there is a plausible mechanism of action, where a metabolically active substance is introduced into the body and produces a biological effect.

You failed to mention the research done with the frequency for inflammation, using the same animal model as used to test most all of the anti-inflammatory drugs. FSM reduced inflammation by 64% in four minutes, and they never found a drug that reduced it more that 45%. Further more, all anti-inflammatory drugs have undesirable side effects some of which can be life threatening.

This is a fair point and I will accept it. I presume you are referring to this study, the reason I did not discuss it was essentially practical in nature, I could only find this one page abstract which was thin on details. There was nothing there I could dissect. Even If I could have found the full paper it is likely I would not have gone over it as I would have felt even less capable of interpreting it than the study I did present. You bring up another point though that I agree with, drugs do have side effects, as do almost all other types of treatments. As I pointed out in my original post the very fact that treatments have an effect on the body opens the possibility that that can have negative as well as positive effects. As far as I can determine the claim that FSM has no negative side effects can neither be proved or disproved, as you seem to confirm the data is simply not there.

You stated two frequencies are employed by Dr. McMakin, however, hundreds of frequencies are employed. There are always at least two frequencies applied at a time, one resonating with a specific tissue and one resonating with a specific condition.

This I think is simply a misunderstanding, I am aware that there are more than two frequencies that can be used, and I do allude to this fact in several places. My apologies for not being clear.

Microcurrent increases cellular energy by 500% and also increases protein synthesis. This is not what I would call a modest claim.

This may be true, here is the study (performed in 1982 and used as a reference for FSM everywhere), this study was on rat skin tissue in vitro and as such can not necessarily be extrapolated to treating the whole body or even significant parts of it for specific diseases. In addition I do not know how these increases affect other biological functioning or whether or not they are significant even in the context given. Indeed though there does seem to be a biological effect produced by the microcurrent and I refer you to my point above regarding potential harm. However my main point of disagreement with the treatment is the “Frequency Specific” part, in other words the claim that each disease has it’s own unique vibration that can be used to treat it, that is the real claim being made and that is the part that I find least convincing.

You state that Dr. Abrams was dismissed as a fraud in the 1920’s. You fail to mention that Dr. Abrams was investigated by Upton Sinclair, who according to Wikipedia, “was a Pulitzer Prize-winning prolific American author who wrote over 90 books in many genres and was widely considered to be one of the best investigators advocating socialist views. He achieved considerable popularity in the first half of the 20th century. He gained particular fame for his 1906 muckraking novel The Jungle, which dealt with conditions in the U.S. meat packing industry and caused a public uproar that partly contributed to the passage of the Pure Food and Drug Act and the Meat Inspection Act in 1906.”

Mr. Sinclair reported that “Albert Abrams was one of the most eminent practitioners in San Francisco, the head physician of large hospitals, recognized as the author of important discoveries.” Like many scientists who make major breakthroughs his ideas which involved a new paradigm in healing were met with disbelief and derision of his peers. Upton Sinclair was very skeptical when he first visited Abrams, and expected to be done in a couple of days. Instead he stayed and observed him for a couple of weeks, “and it might have been months or even years, if urgent duties had not called me home.” Sinclair considered Dr. Abrams to be a great scientist who had much to offer humankind.

No I did not, and would not have even had I been aware of his involvement. The opinions of a single author, even a “Pulitzer Prize-winning” one such as Mr. Sinclair would amount to anecdote. I read the biography of Mr. Sinclair and failed to note any mention of scientific training or any indication that he had any other expertise that might have been relevant, fame and popularity do not a reliable source make. Even if this had not been the case this point would have carried little weight as it is simply an appeal to authority and as such does not trump the decades of knowledge gained since his time. It is the consensus of scientific opinion that should be the more trust worthy authority here, the views of a single person, even a distinguished scientist (or author), are simply too prone to error and bias.

FSM is based on a new paradigm in healing. Dr. McMakin explains it well in simplified terms on a video clip now on her website: www.frequencyspecific.com. If you wish to have a better understanding of the scientific underpinnings of Frequency Specific Microcurrent, I suggest you read Energy Medicine: The Scientific Basis by James Oschman, Ph.D.

The trouble with new paradigms is that they must first prove themselves in the full sphere of scientific knowledge before they can be accepted. This means that they must either fit with the already established principles we have discovered in the realms of physics, chemistry and biology or provide a new underpinning that incorporates the known facts but explains them in a more complete and satisfying way that can be confirmed or falsified by experiment. When “Einsteinian” physics was discovered it did not overturn Newton, it added a new layer of complexity and richness to our understanding of the Universe.

Once again I would like to thank Pamela for her interest and for taking the time to comment without resorting to simple attacks. None of my points have been made in malice and if and offense is given it is with regret.

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This week in my local community paper I had cause to once again raise my brow in surprise at the low bar for inclusion in this publication. I refer to a story written by a journalism student promoting a therapy known as FSM or Frequency Specific Microcurrent (not Flying Spaghetti Monster). I say promoting rather than reporting on as it seemed that the student merely parroted what she had been told of the treatment with nary a skeptical thought. I was unsure when I read this article whether I was looking at a news report or an advertisement for yet another brand of alternative health device. Though I should temper this by pointing out that it seems to be becoming endemic to the field of journalism as a whole rather than be unique to this student of it.

As I could find little in the way of information about this therapy at my usual sources on these sorts of claims (Quackwatch and Skepdic, both excellent resources) I thought I would do some investigation of my own and share the results here. A brief search of PubMed found a decided lack of peer review studies either published by the technology’s alleged inventor Carolyn McMakin, nor on the effectiveness of the therapy itself. So I decided to start with the website of the inventor herself.

The “therapy” consists of applying microamp current to selected areas of the patient’s body, the current is tuned to two different frequencies that historically were supposed to correspond to the resonant frequency of the disease and the tissue of interest. It is unclear whether the current version makes this claim but two frequencies are still employed, apparently providing a unique synergy that is useful for treating only specific ailments. Practically the current is produced by a battery operated device that allows the practitioner to set both the frequency and the current on two independent channels. This current is then transferred to the patient via conductive graphite gloves worn by the practitioner as they lay hands on the patient. The claims for the device itself are modest apparently due to FDA restrictions that apply to the classification of devices it falls under. This classification is that of TENS devices which stands for Transcutaneous Electric Nerve Stimulation, this class of machine can provide relief from certain types of pain simply by virtue of electrical stimulation, no frequencies are explicitly invoked.

However, the frequencies used have much wider claims associated with them, one I found amusing was “There is one frequency combination that so far is 100% effective in a small number of cases to take away kidney stone pain.”, I perhaps naively think that a treatment is either 100% effective or is useful in a small number of cases, combining these two seems to be trying to get the best of both worlds. To clarify I don’t think there are necessarily treatments that are always 100% effective but I do have the opinion that a more useful statement would have been how effective the treatment is for the majority of patients. Other claims include the ability to treat asthma, liver dysfunction and irritable bowel syndrome as well as scar removal.

On the website’s FAQ a simplistic history of the use electromagnetic therapy devices from the early 20th century is given and spoken of in glowing terms stating that “There were thousands of physicians using this technology at this time. They had journals and associations and were treating patients and doing research and sharing the effects of frequencies in articles and books.” This may or may not be true but has no relevance as to the effectiveness of the treatment, I have no doubt there are thousands of practitioners prescribing Homeopathic preparations right now. Dr. Albert Abrams is also referenced as a pioneer of these techniques despite his unusual practices having been exposed as fraud in the 1920s. In 1994 Dr. McMakin started using these frequencies on her chiropractic patients and reports that they “appeared to do exactly what they were alleged to do”.

In 1995 Dr. McMakin developed the therapy using a device and a list of reputedly medically useful frequencies that she apparently inherited from a Canadian osteopath. Two years later Dr. McMakin began teaching FSM according to her website “to see if the effects of FSM were reproducible.” (curious, I thought that’s what studies and controlled trials were for). Despite the order in which the story is related this appears to be before papers were presented to either the American Back Society or Topics in Clinical Chiropractic, both chiropractic based. The teaching of the technique consists of a three day course in “the use of frequency protocols, the differential diagnosis of pain generators and neurologic conditions.”. Were this technique developed by the medical mainstream I hope it would have undergone slightly more rigorous investigation before being tested on patients or taught to other practitioners.

Moving on, there are several papers listed on the website in support of this therapy of mixed quality. The most convincing papers deal with the use of the therapy for Fibromyalgia, in particular this study on “Cytokine changes with microcurrent treatment of fibromyalgia associated with cervical spine trauma“. Now I am not medically trained and readily admit that I am not qualified to accurately interpret the results of this study, however there are several points that I as a layman found concerning. First was the inclusion of only a single control subject who also received treatment. Second there seemed to have been quite a high drop-out rate for the trial (approximately 30%) leaving only 32 subjects to acquire meaningful data from. Thirdly, the use of specific frequencies in the treatment is probably the most controversial part and yet those that were chosen for the study are simply asserted to be the most effective with no reference to how this was done or what data lead to this conclusion. Fourthly, and this is less a criticism of the study itself, is the topic under study. I am given to understand that Fibromyalgia is characterised by periods of flares and remission which may complicate the data. I realise however that this trial may be considered a pilot study and so can not be held to the same standards as a large rigorous placebo/non-treated group controlled trial.

In addition the almost ubiquitous claim in pseudo-scientific medicine and quackery is made that there are no dangers or side effects from the treatment itself. As has been pointed out in other places a modality that affects biological systems is unlikely to be all benefit. If there is an effect then it is almost guaranteed there is a side-effect. The consideration undertaken in the use of valid medical interventions is whether the benefits are worth the accompanying risks.

Due to the nature of the therapy it is unclear exactly what is being tested/providing relief, a shaky theory of dubious plausibility based on the unscientific premise that tissues and diseases have “Frequencies” that if applied externally can enhance or inhibit functioning and so cure medical conditions or transcutaneous electric nerve stimulation that at least one doctor considers to be an uncontroversial treatment for pain. What does seem to be clear is that there seems to be more emphasis on promotion of this therapy than on testing it’s efficacy and introducing to the wider medical community a truly useful technique.

Finally, it seems to me that the evidence is not convincing that there is an effect here that can only be explained by appeals to the recovery of lost knowledge from a golden age of medical treatments that was squashed by a jealous Medical Establishment.

Resources

http://www.frequencyspecific.com

http://www.quackwatch.org/04ConsumerEducation/News/rife.html

http://www.americanartifacts.com/smma/abrams/abrams.htm

http://en.wikipedia.org/wiki/Fibromyalgia

http://en.wikipedia.org/wiki/Transcutaneous_Electrical_Nerve_Stimulator

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As I have pointed out countless times (ok, 4), we are a story telling species, one good anecdote is worth more to most people than a mountain of rigorous evidence and for good evolutionary reasons. This is just a fact of our psychology, it is not just difficult for us to weigh things rationally it is actually going against our basic nature. In recognition of this fact a website has been created to collect stories from around the world that show the real life harm that pseudo-science and other irrational claims can have on individuals. This website is the answer to the oft posed  rhetorical question “What’s the harm?”.

One of the more extreme cases on the site details the story of Sandra Nette, a Canadian woman whose regular visits to a chiropractor resulted in her becoming permanently paralysed. Sandra had been visiting her chiropractor for years to get “maintenance” adjustments that were to keep her healthy, after one such adjustment she began to feel dizzy and unwell. The Chiropractor suggested massage therapy offered at his office and allowed her to leave, she didn’t make it home. After pulling her car over and calling her husband she was taken to the hospital where it was determined that she had tears in both vertebral arteries in her neck which caused a stroke. One of the tears was 3 inches long. According to Sandra’s husband the first words out of the attending physician after reviewing the test results were “chiropractor, right?”.

Now this story in isolation proves nothing about the efficacy or lack thereof of chiropractic, nor does it prove relative safety or harmfulness. However, this is not the point. The point is that other venues have provided evidence of the implausibility and ineffectiveness of this practice and this story is meant to provide a human face to the issue and help people understand, in a way that is real to them and not abstract like a medical study, the possible harm that can be caused. When there is no benefit to a procedure any risk is too much.

Resources

http://WhatstheHarm.net

http://whatstheharm.net/chiropractic.html

http://www.sciencebasedmedicine.org/?p=152

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